Mental Health News You Can Use...
August 2010
Issue 28
This update is from the SAMHSA ADS Center (Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health). SAMHSA ADS Center is a program of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services, Office of Consumer Affairs. The ADS Center helps to promote acceptance and social inclusion for people with mental health problems and helps to counter the negative beliefs, harmful attitudes, and discrimination experienced by those with mental health problems. We encourage you to share this information with others and to post it in your own newsletters or e-mail lists. For more information, please visit the SAMHSA ADS Center Web site: http://www.promoteacceptance.samhsa.gov.
In this issue...
A Letter from the SAMHSA ADS Center
How You Can Make a Difference
Spotlight: Organizations Involved in Mental Health for Military Families
Online Resources
Information and Research
Models, Programs, and Technical Assistance Tools: The Veterans Support Campaign
In My Experience: Abel Moreno
Archived SAMHSA ADS Center Training Teleconferences
A Letter from the SAMHSA ADS Center
It is widely recognized that the ongoing U.S. military deployments to Iraq and Afghanistan have affected the behavioral health of returning service members and their families. This impact is complex and exacerbated by individual and systemic barriers that prevent veterans from seeking and/or receiving behavioral health care.
On July 12, 2010, in his weekly address to the public, United States President Barack Obama announced new policies that will increase access to behavioral health benefits for veterans and their families. These policy changes include increasing and ensuring ongoing funding; expanding mental health counseling and other services for veterans; and implementing a new U.S. Department of Veterans Affairs (VA) directive regarding PTSD—no longer requiring a veteran to provide proof of the specific event that caused his or her PTSD before receiving benefits for treatment. These changes support a policy shift that President Obama expressed in April 2009, when he stated, “the nightmares of war don’t always end when our loved ones return home. . . . Sometimes the deadliest wounds are the ones you cannot see, and we cannot afford to let the unseen wounds go untreated.”
SAMHSA has identified supporting military families as a top strategic initiative, and the agency is working to support service members, their families, and their communities by ensuring that needed behavioral health services are accessible and successful. SAMHSA is committed to increasing access to care through partnerships at both the State and local levels; increasing community and provider awareness and capacity; and, through these efforts, ensuring that returning service members have access to a comprehensive range of services to support their successful reintegration. SAMHSA has partnered with the VA, U.S. Department of Defense (DoD), and other Federal agencies on a series of activities to address the needs of veterans and their families. These include the Veterans Suicide Prevention Hotline at 1–800–273–TALK (8255; veterans press 1); the Building Bridges: Veterans Mental Health Dialogue Meeting and the impending meeting report; a policy academy to promote behavioral healthcare systems for returning service members and their families; national conferences; workshops; trainings; newsletters; magazine articles; and a robust web page of resources on the SAMHSA web site (http://www.samhsa.gov/vets).
On August 3, 2010, as part of SAMHSA’s ongoing effort to bring attention to this important issue, the SAMHSA ADS Center sponsored a free training teleconference entitled Mental Health for Military Families: The Path to Resilience and Recovery. This teleconference featured presentations by three individuals with unique perspectives on this issue: policy expert and veteran Dr. Tom Berger of the Vietnam Veterans of America (VVA); Gulf War veteran and advocate Steve Robinson; and military spouse Sheri Hall, who works closely with the Real Warriors campaign. The presenters discussed barriers to seeking and receiving mental health services; available treatment, services, and supports; the historical context of U.S. military mental health services; the growing concern over increasing suicide rates; and recommendations for improvements and policy changes.
Over 500 participants joined us for this training teleconference. If you are interested in this topic but were unable to participate on August 3, you will be able to access the archived teleconference in late August. Archived teleconferences are available at the following web address: http://promoteacceptance.samhsa.gov/teleconferences/archive/default.aspx
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How You Can Make a Difference
We encourage service members, their families, and others to share their personal recovery stories and information about successful campaigns and programs through two sections on the SAMHSA ADS Center Web site:
These Web pages include links through which you may contact us to share your story or provide information about your program. Through these avenues, you can make a difference in how the public views people with mental health problems.
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Spotlight: Organizations Involved in Mental Health for Military Families
Below, we provide information about a number of organizations and programs that are involved in informing, supporting, serving, and advocating on behalf of service members and their families.
Please note: The descriptions below are pulled from or based upon the language provided on the organizations’ Web sites.
America’s Heroes at Work, a project of the U.S. Department of Labor (DOL), addresses the employment challenges faced by returning service members living with traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), or both. The project equips employers and the workforce development system with the tools they need to help returning service members affected by TBI or PTSD succeed in the workplace. To learn more about America’s Heroes at Work, visit http://www.americasheroesatwork.gov or call 1–866–4–USA–DOL.
The Coalition for Iraq and Afghanistan Veterans (CIAV) is a national non-partisan partnership of organizations committed to working with and on behalf of all military, veterans, families, survivors and providers to strengthen the existing system of care and support for all those affected by the wars in Iraq and Afghanistan. To learn more about CIAV, visit http://coalitionforveterans.org/ciav/home/  .
Defense Centers of Excellence For Psychological Health and Traumatic Brain Injury (DCoE) partners with the DoD; the VA; and a national network of military and civilian agencies, community leaders, advocacy groups, clinical experts, and academic institutions to establish best practices and quality standards for the treatment of psychological health (PH) and TBI. DCoE assesses, validates, oversees, and facilitates prevention, resilience, identification, treatment, outreach, rehabilitation, and reintegration programs to ensure that the DoD meets the needs of military families. DCoE is working to tear down barriers to mental health treatment through the Real Warriors Campaign. Resources for warriors, families, news media, and health professionals are available online at the DCoE Web site (http://www.dcoe.health.mil/Default.aspx) and the Real Warriors Web site (http://www.realwarriors.net/ ). To contact the 24/7 DCoE Outreach Center, call 866–966–1020. A 24/7 live chat option is also available through the Real Warriors Web site: http://www.realwarriors.net/livechat
Families Overcoming Under Stress (FOCUS), a project of the U.S. Navy, is a skills-based resiliency training program that addresses difficulties that families may have when facing the challenges of multiple deployments and combat-related psychological and physical health problems. FOCUS provides services for families based at U.S. Navy, Marine Corps, Army, and Air Force installations. To learn more about this program, visit http://www.focusproject.org or call 310–794–2482.
Iraq and Afghanistan Veterans of America (IAVA) is the country’s first and largest nonpartisan and nonprofit organization working to improve the lives of Operation Iraqi Freedom and Operation Enduring Freedom veterans and their families. IAVA is dedicated to fostering a community for troops, veterans, and their families and advocating on behalf of those who have served. IAVA has undertaken a number of efforts to promote social inclusion and provide veterans and their families with the mental health and peer supports they need. These include a groundbreaking PSA campaign (highlighted in the Models, Programs, and Technical Assistance Tools section of this newsletter) and an annual “Storm the Hill” event, through which veterans meet with lawmakers to discuss legislation that veterans need and deserve. For more information about IAVA, please visit the IAVA Web site: http://iava.org
Military OneSource is a 24/7, toll-free information and referral telephone service available worldwide to service members and their families. The site provides information about topics ranging from everyday concerns to deployment-related issues. Military OneSource is provided by the Department of Defense at no cost to active duty, Guard, and Reserve personnel (regardless of activation status) and their families. It is a virtual extension of installation services. Visit Military OneSource today at http://www.militaryonesource.com , or call 1–800–342–9647. Web site users can order educational materials at no charge and access 24/7 online consultants.
National Military Family Association is a nonprofit organization founded in 1969 by a group of military wives who wanted to ensure that their widowed friends were properly taken care of. Today, the National Military Family Association is an organization that advocates and represents the needs of military families and empowers husbands, wives, and children to understand and access their benefits. They offer a wide range of programs, including a scholarship program for military spouses, family retreats to help with reunification, and summer camps for military children. To learn more about this organization, please visit the organization’s Web site: http://www.militaryfamily.org/
Tragedy Assistance Program for Survivors, Inc. (TAPS) provides ongoing emotional help, hope, and healing to all who grieve the death of a loved one in military service to America, regardless of relationship to the deceased, geography, or circumstance of the death. TAPS provides a national network of peer-based emotional support, casualty case work assistance, crisis intervention, and grief and trauma resources, including grief support resources for children. To learn more about TAPS, visit http://www.taps.org or call the 24-hour support line at 800–959–8277 (TAPS).
Vets4Vets is an organization dedicated to using peer support to help Iraq- and Afghanistan-era veterans heal from the psychological injuries of war. The organization's primary goal is to help these veterans understand the value of peer support and to encourage them to regularly use peer support to express their emotions, manage their challenges, and ease their reintegration into society. To further this goal, Vets4Vets provides free weekend workshops that focus on peer support. More than 1,000 Iraq- and Afghanistan-era veterans have attended workshops over the last 2.5 years, and many have established Vets4Vets groups in their own home communities. To learn more about Vets4Vets, visit http://www.vets4vets.us or call 520–319–5500.
Vietnam Veterans of America (VVA) is an organization dedicated to promoting and supporting the full range of issues important to Vietnam veterans, creating a new identity for this generation of veterans, and changing public perception of Vietnam veterans. The Veterans Health Council, a program of VVA, serves as an information source for Vietnam veterans and veterans of more recent wars. It aims to inform veterans and their families about health issues and available military benefits, educate providers and educational institutions about health issues associated with military service, and support veteran-related healthcare initiatives. For more information about VVA, visit http://vva.org or call 800–VVA–1316.
Wounded Warrior Project is a nonprofit organization that supports severely wounded service members and helps them both physically and mentally on the road to healing. The project aims to (1) raise awareness of and enlist the public’s aid for the needs of severely injured service members, (2) help severely injured service members aid and assist each other, and (3) provide unique, direct programs and services. For more information, visit http://www.woundedwarriorproject.org or call the office headquarters at 877–832–6997.
For a listing of additional veteran service organizations, visit the following Web address: http://www1.va.gov/vso/index.cfm?template=view
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Online Resources
Below, we provide information about online resources relevant to mental health and military families.
Please note: The descriptions below are pulled from or based upon the language provided on the organizations’ Web sites.
Afterdeployment.org (AD)
http://www.afterdeployment.org
AD, operated by the DCoE, uses simple and private interaction, including self-assessment with feedback and recommendations. AD’s Web site addresses post-deployment issues of warriors and their families. Several online programs offer support for concerns such as depression, stress, relationships, difficulties at work, anger management, sleep problems, alcohol and drugs, and more. Other specialized programs include spirituality, living with physical injuries, stigma, and mild TBI. AD also provides a program for helping children deal with deployment and separation. AD is designed for active duty service members, veterans, and their families but is available to anyone and may be accessed anonymously.
National Resource Directory (NRD)
http://www.nationalresourcedirectory.gov/
NRD is a Web site for wounded, ill, and injured service members and veterans; their families; and those who support them. The DoD, DOL, and VA together created this online tool, which provides access to more than 10,000 programs, services, and resources at the national, State, and community levels. These resources support recovery, rehabilitation, and community reintegration. The Web site offers information on a variety of topics, including benefits and compensation, education and training, employment, family and caregiver support, health, homeless assistance, housing, and transportation and travel.
Military Pathways
http://www.militarymentalhealth.org
Military Pathways is a DoD–nonprofit collaboration with three primary goals: reduce negative perceptions, raise awareness about mental health, and connect those in need to available resources. Service members may log in and select an anonymous screening. The site then recommends next steps.
Post Deployment Stress
The RAND Center for Military Health Policy Research conducted literature reviews, solicited expert feedback, and facilitated focus groups to create two booklets related to post-deployment stress. One booklet addresses the concerns of service members returning from deployment in Iraq or Afghanistan, while the other addresses the concerns of their family members. Both booklets include information about PTSD, TBI, and other emotional and behavioral problems that returning service members may face:
SAFE Program: Mental Health Facts for Families
http://www.ouhsc.edu/safeprogram
This online manual was developed by Dr. Michelle D. Sherman, Director of the Family Mental Health Program at the Oklahoma City VA Medical Center. Facilities use this manual to conduct an 18-session family education program for people who care about someone living with PTSD or mental health problems. The program is facilitated by mental health professionals, and a National Alliance on Mental Illness representative attends each session. The manual includes more details on how to conduct the program.
Talk, Listen, Connect: Deployments, Homecomings, Changes
http://archive.sesameworkshop.org/tlc/
Sesame Workshop presents this bilingual (English and Spanish) multimedia outreach program designed to support military families with children between the ages of 2 and 5 who are experiencing deployment, multiple deployments, or change in a parent's return home due to combat-related injury.
Understanding Military Culture When Treating PTSD
http://www.ptsd.va.gov/professional/ptsd101/flash-files/Military_Culture/player.html
This online course, created by the National Center for PTSD, presents important information for clinicians treating patients with PTSD. The course covers military demographics, branches, ranks, status, and stressors. Dr. Patricia J. Watson provides useful terminology and visuals to help viewers understand military culture. She also describes two programs created to help service members prevent and manage combat and operational stress: Army Battlemind and Marine Corps Combat Operational Stress Continuum.
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Information and Research
Adler, A. B., Bliese, P. D., McGurk, D., Hoge, C. W., & Castro, C. A. (2009). Battlemind debriefing and battlemind training as early interventions with soldiers returning from iraq: Randomization by platoon. Journal of Consulting and Clinical Psychology, 77(5), 928–940.
Barber, J. A., Rosenheck, R. A., Armstrong, M., & Resnick, S. G. (2008). Monitoring the dissemination of peer support in the VA healthcare system . Community Mental Health Journal, 44(6), 443–441. doi: 10.1007/s10597-008-9146-7
Bartone, P. T. (2006). Resilience under military operational stress: Can leaders influence hardiness? Military Psychology, 18, S131–S148. doi: 10.1207/s15327876mp1803s_10
Chinman, M., Lucksted, A., Gresen, R., Davis, M., Losonczy, M., Sussner, B., et.al. (2008). Early experiences of employing consumer-providers in the VA. Psychiatric Services, 59(11), 1315–1321.
Jakupcak, M., Cook, J., Imel, Z., Fontana, A., Rosenheck, R., & McFall, M. (2009). Posttraumatic stress disorder as a risk factor for suicidal ideation in Iraq and Afghanistan War veterans . Journal of Traumatic Stress, 22(4), 303–306. doi: 10.1002/jts.20423
Jarret, T. (2008, July–Sep). Warrior resilience training in Operation Iraqi Freedom: Combining rational emotive behavior therapy, resiliency, and positive psychology. U.S. Army Medical Department Journal,32–38.
McNulty, P. A. F. (2010). Adaptability and resiliency of military families during reunification: Initial results of a longitudinal study . The Federal Practitioner, 27(3), 18–27.
Pietrzak, R. H., Johnson, D. C., Goldstein, M. B., Malley, J. C., & Southwick, S. M. (2009). Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom. Depression Anxiety, 26(8), 745–751.
Resnick, S. G., & Rosenheck, R. A. (2008). Integrating peer-provided services: A quasi-experimental study of recovery orientation, confidence, and empowerment. Psychiatric Services, 59(11), 1307–1314.
Tuerk, P. W., Grubaugh, A. L., Hamner, M. B., & Foa, E. B. (2009). Diagnosis and treatment of PTSD-related compulsive checking behaviors in veterans of the Iraq War: The influence of military context on the expression of PTSD symptoms . The American Journal of Psychiatry, 166,762–767.
Yaffe, K., Vittinghoff, E., Lindquist, K., Barnes, D., Covinsky, K. E., Neylan, T., et al. (2010). Posttraumatic stress disorder and risk of dementia among US veterans . Archives of General Psychiatry, 67(6), 608–613.
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Models, Programs, and Technical Assistance Tools: The Veterans Support Campaign
In March 2010, the Veterans Support Campaign received a Gold Ogilvy Award for the Public Service Announcement (PSA) “Alone,” which features two Iraq veterans and Purple Heart recipients, Bryan Adams and Todd Bowers. Adams is shown returning from combat to an empty New York City. As he comes to an empty intersection, Bowers approaches and extends his hand. Through this powerful connection, the streets come alive—demonstrating the importance of veteran-to-veteran connections. The powerful PSA was recognized because of the research and creativity used to develop it.
The Veterans Support Campaign, launched on Veterans Day 2008, is an effort of the Iraq and Afghanistan Veterans of America (IAVA) and the Ad Council. The campaign and IAVA continue to blaze a trail in veteran-to-veteran support and to reframe how communities embrace returning veterans. The campaign’s first round of PSAs, which includes “Alone,” publicizes the first-ever online community designed exclusively for returning veterans: http://www.communityofveterans.org . The site is a social network to support veterans as they reintegrate into society—an important endeavor aimed at addressing the behavioral health and societal hurdles many veterans face upon returning home. IAVA Executive Director Paul Rieckhoff explains, “Veterans want to be linked up with other veterans who understand. This campaign does exactly that, and reaches new veterans where they already are – online.”
In April 2009, the campaign expanded its PSA efforts and its online presence to include a place for friends and family members of returning veterans. The second round of PSAs emphasizes the importance friends and family members play in supporting veterans’ successful reintegration into the daily activities of noncombat life. The PSAs refer friends and family members to http://www.supportyourvet.org , where they can talk to others and find information about the transition from combat to society, resources on the invisible injuries of war, tips on starting conversations with veterans, stories from others like them, and resources for navigating the VA system.
All campaign efforts are based on extensive research conducted through focus groups, consultation with Iraq and Afghanistan veterans, and guidance from a panel of mental health experts. The PSAs were created pro bono by advertising agency BBDO; media spots were secured through donation; and numerous others have shown support of what Rieckhoff terms “the welcome home that our newest generation of heroes [has] been waiting for.”
The campaign continues to promote systemic changes to encourage social inclusion for returning veterans with behavioral health needs. For more information about the Veterans Support Campaign, visit http://iava.org/press-room/press-releases/iava-and-ad-council-launch-historic-campaign or contact Chrissy Stevens at 212–982–9699 or chrissy@iava.org.
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In My Experience: Abel Moreno
There was a time . . .
By Abel Moreno
There was a time when the future I hoped for was mired by the grips of reality. I was in search of a job and a good one. My wife and I had two children and one on the way. Being recently out of the Army and having a “pie in the sky” expectation of receiving the good pay that everyone talks about, I was determined to find a job. I, of course, applied for everything from plumber to hall monitor at a middle school (I got the job, and it was not cool). I worked “under the table” construction when I could and barely made ends meet, even with financial help from loved ones.
Lo and behold, I eventually got a clinical aide spot at a local behavioral health agency. The experience was an extreme shock, considering the life I had led for the past 7 years. However, at this place of employment, I realized what I wanted and felt I needed to do: help people. Well, I realized that, but at this place of employment, I was a paper-runner and a notetaker—nothing big, but it was a start.
I encountered a lot of biased perceptions of me, for all kinds of reasons: I was too young; I was not experienced enough to manage a crisis; or plainly, I was “just a dumb Army guy who fought in a war.” The fact was, I knew crisis; I was young but had the mind of a fifty-year-old man; and of course, I had fought in a war. The last part is true, but what would those who criticized me know about that? Still, I knew what I wanted to do; I wanted to help people. I realized that by giving something purely from my heart, I could gain something too—I could win back my soul.
Finally in 2006, I started a job as a street outreach worker, helping people who are homeless, and I began to feel that I was winning back my soul. I saw what the greater slums of Tucson had to offer: sex workers, abused women, substance abusers, alcoholics, felons, convicts, parolees . . . young and old—all in need of some kind of help. I witnessed the extreme joy of someone receiving the result “negative” from an HIV test, and I saw the extreme sadness of someone who tested positive. I have seen drug abuse engulf a man to his last breath. I re-learned who I am and developed my own beliefs, ones built not on the perceptions of others nor through opposition to some partisan belief. I opened my mind and realized that heart and compassion would be my newfound weapons. I had learned myriad lessons as a social worker, a profession I didn’t expect. These invaluable lessons were my new redemption.
My latest lesson, I learned from a man I met in the park. He wore a 101st patch on his OD green jacket. He had been drinking for 4 days straight, and he laughed when he saw my long hair and my 82nd Airborne belt buckle. I asked him what had happened, why the streets. He asked me, “Well, son, have you fought for this country?” As tears began to well up in my eyes, I answered him, “yes.” “Well then, you know.” His wife and children left him long ago and disowned him. I asked him, “Does this ever go away?” “I don’t know, but then again, I never tried to make it either.”
I believe it all came clear after that last and final lesson; it was months later that I met a Vietnam veteran who was putting together a program involving peer-support for Afghanistan- and Iraq-era veterans. I quickly applied and experienced the three-day workshop that opened my eyes to my own distress. I was hired as a media coordinator to help develop a national network of Afghanistan- and Iraq-era veterans. I believe this to be the path that I have been set on. I am currently the Deputy Director of Vets4Vets, a national peer-support network with its own brand and design of peer support.
I came to grips with my emotional stress through this program and now help my returning brothers and sisters to do the same. It has been a long road, but the challenges I faced and continue to face will always provide perspective and direction.
Abel Moreno (abel@vets4vets.us) is an Afghanistan and Iraq war veteran and Deputy Director/Co-Founder of Vets4Vets. Contact Vets4Vets by visiting http://www.Vets4Vets.us or calling 520–319–5500.
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Archived SAMHSA ADS Center Training Teleconferences
All SAMHSA ADS Center teleconferences are archived and posted to the SAMHSA ADS Center Web site, generally within 3 weeks of the teleconference. Other recent teleconferences include Building an Inclusive Society: In Recognition of the 20th Anniversary of the Passage of the Americans with Disabilities Act; The Power of the Media and Its Impact on Mental Health Recovery; The History of the Mental Health Consumer/Survivor Movement;and IT Strategies to Promote Social Inclusion.
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